Health care denied

July 17, 2006

Last year, the Maryland General Assembly unanimously approved legislation to make prescription drugs more affordable for an estimated 38,000 uninsured state residents. The concept was relatively simple: Let eligible people (individuals earning $19,140 or families of four earning $38,700 per year) purchase prescription drugs at Medicaid-negotiated prices, an estimated 40 percent savings. The cost to the state was relatively small - $1 million to $2 million per year - and the cost to the federal government would be nil.

Gov. Robert L. Ehrlich Jr. agreed. For a modest investment, the state could make sure a sizable number of people with no health insurance - and who aren't Medicaid-eligible - could pay a fair and reasonable price for medication.

Unfortunately, it appears the Bush administration doesn't see it that way. State officials revealed last week that representatives of the U.S. Department of Health and Human Services have informally told them that Maryland's drug purchase program has been denied the needed Medicaid waiver. Their reasoning? S. Anthony McCann, secretary of Maryland's Department of Health and Mental Hygiene, said he was told that the state's investment in the program was insufficient under the law.

But that explanation seems inadequate. The legislation passed in 2005 left it up to DHMH to determine how large a subsidy to provide beneficiaries. Health care advocates suspect the real problem is that the Bush administration has taken the side of drug manufacturers who oppose the waiver and fear other states would copy Maryland's concept. That could cost the industry tens of millions of dollars in profits.

Mr. Ehrlich, however, is in the perfect position to lobby President Bush and negotiate a waiver proposal that can pass muster with the White House. That would enable the governor to demonstrate not only his commitment to affordable health care but also some clout in Washington. The latter is a quality Democrats often claim he lacks despite his eight years in Congress and friendship with George W. Bush.

Of course, this program is just one modest step toward helping Maryland's uninsured; certainly, more needs to be done. But we can't think Mr. Ehrlich will accept this setback without a fight - or at least a word in the ear of his ally in the White House.